Medical Plans

The primary objective of an HMO is to have only one physician coordinate a patient’s care through the HMO network of physicians, medical offices and hospitals. Under this plan, you MUST choose a Primary Care Physician (PCP) and a medical group from the HMO Network. If you do not, Anthem will assign a PCP and medical group to you.

The EPO plan offers a local network of doctors and hospitals for you to choose from. There is no requirement to designate a Primary Care Physician (PCP) or obtain referrals to specialists. An EPO is usually more pocket-friendly than a PPO plan. However, care outside the network is not covered except in an emergency.

The PPO plan offers you the freedom to go in and out of the network for care. You may use a PPO provider whose negotiated rates provide richer levels of benefits, with claim forms filed by the provider. You may also obtain services outside the PPO network; however, you will incur higher out of pocket expenses and you are responsible for filing claims.